2012-03-06T13:37:40-06:00 2011-12-31 550521993 TOOTHMAN RICE PLLC PO BOX 908 BRIDGEPORT WV 26330 990 2011-01-01 550730654 DIGNITY HOSPICE OF SOUTHERN WV INC DIGN 3048554764 P O BOX 4565 CHAPMANVILLE WV 25508 DENNIS R LEWIS 3048554764 2012-03-06 1 P00089711 3046245471 2012-03-06 2011 2016-02-24 21:20:13Z DENNIS R LEWIS P O BOX 4565 CHAPMANVILLE WV 25508 2532946 0 X WWW.DIGNITYHOSPICE.ORG X 1994 WV DIGNITY HOSPICE PROVIDES SERVICES TO TERMINALLY ILL PATIENTS AND PROVIDES EMOTIONAL AND PSYCHOLOGICAL SUPPORT TO THE RESPECTIVE FAMILY MEMBERS. 4 4 70 20 23522 -881 69972 54130 3373678 2451817 3129 216 18140 26783 3464919 2532946 0 0 0 0 1319368 1510036 0 0 4482 1792567 1168311 3111935 2678347 352984 -145401 2088912 2037985 853775 948249 1235137 1089736 DIGNITY HOSPICE PROVIDES SERVICES TO TERMINALLY ILL PATIENTS AND PROVIDES EMOTIONAL AND PSYCHOLOGICAL SUPPORT TO THE RESPECTIVE FAMILY MEMBERS. 0 0 2180994 2455294 THE HOSPICE PROVIDED CARE TO TERMINALLY ILL PATIENTS AND THEIR FAMILY MEMBERS, 17,500 UNITS OF SERVICE, PROVIDED COMMUNITY EDUCATION, AND PROVIDED CHARITY CARE INCLUDING MEDICAL SUPPLIES 2180994 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 6 0 1 70 1 1 1 0 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WV X DENNIS LEWIS 3048554764 P O BOX 4565 MAIN STREET CHAPMANVILLE WV 25508 KENT BOWKER 1.00 X 0 0 0 STEPHEN NICHOLS 1.00 X 0 0 0 JAMES GREG DALTON 1.00 X 0 0 0 NANCY GODBY 1.00 X 0 0 0 0 0 0 0 0 0 0 0 54130 54130 PROGRAM SERVICE REVENU 621610 2451817 2451817 2451817 216 216 23522 23522 23522 23522 OTHER REVENUE 621610 3261 3261 3261 2532946 2455294 23522 0 1159249 930877 228372 8249 6624 1625 238831 191781 47050 103707 83277 20430 10046 10046 18523 18523 672436 672436 87298 30249 52567 4482 6597 2330 4267 108873 59880 48993 162702 136924 25778 45024 22512 22512 20762 10381 10381 36050 33723 2327 2678347 2180994 492871 4482 40938 15805 223734 227029 812660 815219 20980 8393 1345739 374200 990600 971539 2088912 2037985 191243 324750 662532 623499 853775 948249 X 0 0 0 0 1235137 1089736 1235137 1089736 2088912 2037985 -145401 0 X 1 0 0 X 0 X 47165 114645 52793 69972 57391 341966 2277783 2614123 3094785 3198293 2449258 13634242 2324948 2728768 3147578 3268265 2506649 13976208 0 0 0 13976208 31791 54499 20355 21270 23522 151437 31791 54499 20355 21270 23522 151437 2356739 2783267 3167933 3289535 2530171 14127645 0.98930 0.98860 0.01070 0.01140 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 731000 731000 346053 117876 228177 268686 256324 12362 971539 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION RECEIVES ITS FORM 990 PRIOR TO ITS BOARD MEETING AND THE REPORT IS DISCUSSED AT THAT MEETING PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY THE BOARD IS ASKED TO COMPLETE A CONFLICT OF INTEREST SURVEY. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD REVIEWS THE COMPENSATION OF THE EXECUTIVE DIRECTOR AND ALL THE KEY EMPLOYEES WHEN THE CONTRACTS FOR THESE POSITIONS ARE NEGOTIATED. THE COMPENSATION RATES ARE COMPARED TO OTHER SIMILAR FACILITIES IN THE STATE, AND TO NATIONALLY PUBLICALLY AVAILABLE DATA. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS DOCUMENTS AVAILABLE AT ITS MAIN OFFICE FOR ANY INDIVIDUALS THAT ARE INTERESTED IN SEEING THEM AND MAKES A REQUEST.